Yifei Duan and colleagues describe a 6-month-old exclusively breastfed girl in Chengdu whose blood lead was above 200 µg/L at a routine check in May 2020 and rose to 454.0 µg/L despite a month of oral calcium. Her mother’s blood lead was 77.0 µg/L and her father’s 36.9 µg/L. The mother had used a traditional Chinese topical powder, printed in the paper as Hu Wang Fen, on her own armpits and under her breasts for a long time to keep the skin dry. The powder contained 180.1 ± 0.6 mg/kg lead. Breast milk contained 10.0 ± 0.7 µg/L lead, which the authors describe as not significantly different from normal breast milk. The infant received three cycles of edetate calcium disodium chelation.
The powder was applied to the mother, not to the infant. The authors infer transfer by skin-to-skin contact and hand-to-mouth activity. They do not measure it.
Key numbers
| Matrix | Date or stage | Lead | Unit |
|---|---|---|---|
| Topical powder used by the mother | measured after the parental blood tests | 180.1 ± 0.6 | mg/kg |
| Breast milk | same period | 10.0 ± 0.7 | µg/L |
| Mother, whole blood | after the infant’s 28 June 2020 hospital visit (date not printed) | 77.0 | µg/L |
| Father, whole blood | same visit (date not printed) | 36.9 | µg/L |
| Infant, whole blood | 18 May 2020 | more than 200.0 | µg/L |
| Infant, whole blood | 4 June 2020 | 429.9 | µg/L |
| Infant, whole blood | 28 June 2020 | 454.0 | µg/L |
| Infant, whole blood | 31 July 2020 | 435.0 | µg/L |
| Infant, whole blood | after three chelation cycles (Figure 2: 24 August 2020) | 272 | µg/L |
| Infant, whole blood | 27 January 2022 | 84.29 | µg/L |
The text says the last test was “after 5 months”. The printed date, 27 January 2022, is about 17 months after discharge on 24 August 2020, and Figure 2 prints the same date. Both are kept.
The paper compares the powder with a national food safety standard of 5 mg/kg and a “National Cosmetics Hygiene Standard” of 40 mg/kg. The in-force Chinese cosmetics standard of 2015 sets lead at 10 mg/kg (see 化妆品安全技术规范 (2015年版)). The powder is above either figure.
Methods (brief)
Blood lead was measured in the hospital’s laboratory medicine department. The report does not state the method used for the powder or the milk, the number of replicates behind the ± values, or the laboratory. Chelation used edetate calcium disodium 200 mg by 12-hour intravenous infusion daily for 4 days per cycle, three cycles with 3-day rests, with calcium gluconate 250 mg/day.
The discussion notes that red and yellow lead-oxide powders have been used in several Chinese provinces to prevent and treat diaper rash, infant eczema, heat rash, and red buttocks, and that children with lead poisoning from them have been reported from Shanghai and Hunan. The authors speculate that the powder in this case belongs to the same family, based on appearance and purpose. This is the authors’ reading. The paper does not identify the lead compound in the powder.
Evidence fitness
The report documents that a traditional topical powder with lead near 180 mg/kg was present in the household of an infant with blood lead above 400 µg/L, and that the infant’s blood lead fell after use stopped and chelation began. It is a single case. It is not evidence about commercial baby powders.
Limitations
One patient, one product sample, no analytical method for the product, and an inconsistent interval for the final blood test. The source is routed to the children’s personal care hub because no product row covers traditional lead-oxide powders; that taxonomy gap is logged for review. Supplementary material is referenced online and was not obtained. The corresponding author is Yu Gou (tgyx2021@126.com).
Related evidence
- Children Personal Care (HMT&C Category 2 master)
- Lead
- Cat 2 (Children Personal Care) non-ingestion exposure pathways
Update history
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